Individual provider Active NPI

Kelly Stech, MS, CCC-SLP

  • Speech-Language Pathologist
  • Smithtown, NY
National Provider Identifier
1174092803
Registry record updated Nov 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Practice address
732 Smithtown Byp Ste 303
Smithtown, NY 11787-5020
Phone
(631) 319-3350
NPI assigned
Nov 26, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X Primary

Addresses

Primary practice location

732 Smithtown Byp Ste 303
Smithtown, NY 11787-5020

Mailing address

468 Gibbs Pond Rd
Nesconset, NY 11767-2111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220808000990 NY Practitioner - Qualified Speech Language Pathologist 8022490077 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Little Angels Center, Inc Speech-Language Pathologist CurrentSince May 1, 2022 Accepting new patients

Locations

235 Blue Point Ave
Blue Point, NY 11715
Phone (631) 363-5794

77 N Centre Ave
Ste 215
Rockville Ctr, NY 11570
Phone (631) 363-5794

1490 William Floyd Pkwy
Ste 107
Shirley, NY 11967
Phone (631) 363-1980

732 Smithtown Byp
Ste 303
Smithtown, NY 11787
Phone (631) 319-3350

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1174092803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 GIBBS POND RD",
            "city": "NESCONSET",
            "state": "NY",
            "postal_code": "117672111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 SMITHTOWN BYP STE 303",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117875020",
            "telephone_number": "631-319-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STECH",
        "first_name": "KELLY",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smithtown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.